POS0776 STUDY OF GROWTH AND DEVELOPMENT IN INDIAN PATIENTS WITH ENTHESITIS RELATED ARTHRITIS CATEGORY OF JUVENILE IDIOPATHIC ARTHRITIS
Authors: S. Mukherjee, N. Kamble, P. Kumar, U. Dhakad
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile Idiopathic Arthritis (JIA) is an umbrella term for chronic arthritis with onset before 16 years of age. According to ILAR classification criteria it is subdivided in 6 category. Growth failure is a well observed phenomenon in JIA and more so in Systemic onset and polyarticular variants. Except from western literature, in Asian countries Enthesitis Related arthritis (ERA) is more prevalent. In our study, we have studied the growth and development of patients with Enthesitis Related arthritis variant. <h3>Objectives</h3> To assess the prevalence of growth failure and sexual maturity in patients with JIA-ERA and possible association with disease activity, damage and drug therapy. <h3>Methods</h3> We have enrolled all patients of JIA-ERA, visiting rheumatology outdoor patient service in KGMU, Lucknow, from July 2021 to Dec 2021. All the patients must qualify Revised ILAR classification criteria for ERA. Those who have concomitant developmental disorders, secondary amyloidosis and macrophage activation syndrome were excluded from the study. All patients were clinically examined and previous medical records were thoroughly checked. Anthropometric measurement and tanner staging was done at baseline. Growth velocity was observed at follow up visit. This is a Prospective observational study with follow up at 3 and 6 months. <h3>Results</h3> 50 patients of JIA-ERA were enrolled. Majority of them were boys with a male to female ratio of 4.5:1 and mean age of 15.5 years. Mean age of onset was 11.5 years with a mean disease duration of 41.25 months. 32% had family history of SpA in first degree relatives and 12 % had history of uveitis in parents. Only 3 patients (6%) had history of other autoimmune diseases in family. There was no developmental delays in children with JIA-ERA and 47 patients (94%) were vaccinated for their age. 76% patients had inflammatory back pain with significant early morning stiffness at baseline and 18% had purely axial involvement. 20% had active or past history of uveitis, 12% had dactylitis and 30% had enthesitis (predominantly Achilles enthesitis). 76% had achieved age appropriate linear growth with 20% were 2SD above their mid parental height. 12 patients (24%) had significant limb length discrepancies. 64% were underweight for their age with low BMI. 30% patients had delayed sexual maturity in terms of sparse axillary and pubic hair with low tanner stage for that age. In majority of cases growth velocity of 4cm/6month was observed which was quite similar to the pubertal growth spurt of normal reference value. No significant association of growth failure was observed with prior corticosteroid use, disease duration, disease activity (JSPADA and JADAS27) and damage (JADI) score. <h3>Conclusion</h3> Growth failure wasn't well observed in JIA-ERA variants. One third had delayed sexual maturity for their age. Growth velocity was similar to age matched healthy population. No significant association was found with prior corticosteroid use, disease duration, disease activity or damage score. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.